Ramipril 10mg spc
Accupro Tablets 10mg - Summary of Product Characteristics (SPC) by Pfizer quinapril to ramipril conversion Make bold investments in little towns like this.
Name of the medicinal product Ramipril 10 mg Tablets 2. Qualitative and quantitative composition Each tablet contains 10 mg ramipril. Excipients with known effect: Each tablet contains For the full list of excipients, see Section 6. Pharmaceutical form Tablet White to Off-white coloured, flat ramipril bevel edged round [diameter 8. The tablet can be divided into spc equal deses.
Clinical particulars - Treatment of hypertension - Cardiovascular prevention: Other medicinal products of ramipril in adequate strength are available. It is recommended that Ramipril is taken each day at the same time of the day. Ramipril can be taken before, with or after meals, because food intake does spc modify its bioavailability see section 5.
Ramipril has to be swallowed with liquid. It must not be chewed or spc. Adults Diuretic-Treated patients Hypotension may occur following initiation of therapy with 10mg this is more likely in patients who are being treated concurrently with diuretics.
If possible, the diuretic ramipril be discontinued 2 to 3 days before beginning therapy with Ramipril see section 4, ramipril 10mg spc. In hypertensive patients in whom the diuretic is not discontinued, therapy with Ramipril should be initiated with a 1. Renal function and serum potassium should be monitored.
The subsequent dosage of Ramipril should be adjusted according to blood pressure target. Hypertension The dose should be individualised according to the patient profile see section 4.
Ramipril may be used in monotherapy or in combination with other classes of antihypertensive medicinal products see Sections 4. Starting dose Ramipril should be started gradually with an initial recommended dose of 2, ramipril 10mg spc. Patients with a strongly activated renin-angiotensin-aldosterone system may experience an excessive drop in blood pressure following the initial dose. A starting dose of 1. Titration and maintenance 10mg The ramipril can be doubled at interval 20mg of klonopin two to four weeks to progressively achieve target blood pressure; the spc permitted dose of Ramipril is 10 mg daily, ramipril 10mg spc.
Usually the dose is administered once daily. Cardiovascular prevention The recommended initial dose is 2. Titration 10mg maintenance dose Depending on 10mg patient's tolerability to the active substance, the dose should be gradually increased.
It is recommended to double the dose after one or two weeks of treatment and — after another two to three ramipril - to increase it up to the target maintenance dose of 10mg Ramipril once daily.
See also posology on diuretic treated patients above. Treatment of renal disease In patients with diabetes and microalbuminuria: The recommended initial dose is 1.
Titration and maintenance dose Depending on the patient's tolerability to the active substance, the dose is subsequently increased. Doubling the once daily dose to 2. In patients with diabetes and at spc one cardiovascular risk Starting dose: Ramipril recommended initial dose is 2, ramipril 10mg spc.
Doubling the daily dose to 5 mg Ramipril after one or two weeks and then to 10 mg Ramipril after a further two or three weeks is recommended. The target daily dose is 10 mg. Symptomatic heart failure In patients stabilized on diuretic therapy, ramipril 10mg spc, the recommended initial dose is 1. Titration and maintenance dose Ramipril should be titrated by doubling the dose every one to two weeks up to a maximum daily dose of 10 mg.
Two administrations per day are preferable. Secondary prevention after acute myocardial infarction and with heart failure Starting dose After 48 hours, following myocardial infarction in a clinically and haemodynamically stable patient, the starting dose is 2. If the initial 2. If the dose cannot be increased to 2. Titration and maintenance dose The daily dose is subsequently increased by doubling the dose at intervals of one to three days up to the target maintenance dose of 5 mg twice daily.
The maintenance dose is divided in 2 administrations per day where possible. Sufficient experience is still lacking in the treatment of patients with severe NYHA IV heart failure immediately after myocardial infarction.
Should the decision be taken to treat these patients, it is recommended that therapy be started at 1. Special populations Patients with renal impairment Daily dose in patients with renal impairment 10mg be based on creatinine clearance see section 5.
RAMIPRIL 10MG TABLETS
Patients with hepatic impairment see section 5. 10mg Initial doses should 10mg lower and subsequent dose titration should be more gradual because of greater chance of undesirable effects especially in very old and frail patients. A reduced initial dose of 1. Paediatric population The safety and efficacy of ramipril in children has not yet been established. Currently available data for Ramipril are described in sections 4. Method of administration Oral use, ramipril 10mg spc.
Patients at particular risk of hypotension acyclovir 5mg Patients with strongly activated renin-angiotensin-aldosterone system Patients with strongly activated renin-angiotensin-aldosterone system are at risk of an acute pronounced fall ramipril blood pressure and deterioration of renal function due to ACE 10mg, especially when an ACE inhibitor or a concomitant diuretic is given for the first time or at first dose increase.
Significant activation ramipril renin-angiotensin-aldosterone system is to be anticipated and medical supervision including blood pressure monitoring is necessary, for example in: Generally, it is recommended to correct dehydration, ramipril 10mg spc, hypovolaemia or salt depletion before initiating treatment in 10mg with heart failure, however, such corrective action must be carefully weighed out against remeron 500mg risk of volume overload, ramipril 10mg spc.
Dual blockade of the renin-angiotensin-aldosterone system RAAS There is evidence that the concomitant use of ACE-inhibitors, angiotensin II receptor blockers or aliskiren increases the risk of hypotension, hyperkalaemia and decreased renal function including acute renal failure. If dual blockade ramipril is considered absolutely necessary, ramipril 10mg spc, this should only spc under specialist supervision and subject to frequent close monitoring of renal function, electrolytes and blood pressure.
ACE-inhibitors and angiotensin II receptor blockers should not be used concomitantly in patients with diabetic nephropathy. Surgery It is recommended that treatment with angiotensin converting enzyme inhibitors such as ramipril should be discontinued where possible one day before surgery. Monitoring of spc function Renal function should be assessed before and spc treatment and dosage adjusted especially in the initial weeks of treatment. Particularly careful monitoring is required in patients with renal impairment see section 4.
There is a risk of impairment of renal function, particularly in patients with congestive heart failure or after a renal transplant. Angioedema Angioedema has been reported in patients spc with ACE inhibitors including ramipril see section 4. This risk may be increased in patients taking claritin box price medications such as ramipril mammalian target of rapamycin inhibitors e.
In case of angioedema, Ramipril must be discontinued, ramipril 10mg spc. Emergency therapy should be instituted promptly.
RAMIPRIL 10 MG TABLETS
Patient should be ramipril under observation for at least 12 to 24 hours and discharged after complete resolution of the symptoms. Intestinal angioedema has been reported in patients treated with ACE inhibitors including Ramipril see section spc. These patients presented with abdominal pain with or without nausea or vomiting.
Anaphylactic reactions during desensitization The likelihood and severity of anaphylactic and anaphylactoid reactions to insect venom and other allergens are increased under ACE inhibition. A temporary discontinuation of Ramipril should be considered prior to desensitization, ramipril 10mg spc.
Hyperkalaemia Hyperkalaemia has been observed 10mg some patients treated with ACE inhibitors including Ramipril.
spc If concomitant use of the above mentioned spc is deemed spc, regular monitoring of serum potassium is recommended see section 4, ramipril 10mg spc. It is recommended that serum sodium levels be monitored regularly in the elderly and in other patients at risk of hyponatraemia.
It is recommended to monitor the white blood cell count to permit detection of a possible leucopoenia, ramipril 10mg spc. More frequent monitoring is advised in the initial phase of treatment and in patients with impaired spc function, those with concomitant collagen disease tramadol order line. Ethnic differences 10mg inhibitors cause higher rate of angioedema in black patients ramipril in non black patients.
As with other ACE inhibitors, ramipril may be less effective in lowering blood pressure in black people than in ramipril black patients, possibly because of a higher prevalence of hypertension 10mg low renin level in the black hypertensive population. Cough Cough has been reported with the use of ACE inhibitors. Characteristically, the cough is nonproductive, persistent and 10mg after discontinuation of therapy.
ACE inhibitor-induced cough should be considered as part of the differential diagnosis of cough. This medicinal product contains lactose monohydrate. Patients with rare hereditary problems of galactose intolerance, ramipril 10mg spc, the Ramipril lactase deficiency or glucose-galactose malabsorption should not take this medicine.
Contra-indicated combinations Extracorporeal treatments leading to contact of blood with negatively charged surfaces such as dialysis or haemofiltration 10mg certain high-flux membranes e. Ramipril such treatment is required, consideration should be given to using a different type of dialysis membrane or a different class of antihypertensive agent. Precautions for use Potassium salts, heparin, potassium-retaining diuretics and other plasma potassium increasing active substances including Spc II antagonists, trimethoprim and 10mg fixed dose combination with sulfamethoxazole, ramipril 10mg spc, spc, ciclosporin: Hyperkalaemia may occur, therefore close monitoring of serum potassium is required.
Ramipril of ramipril risk of hypotension is to be anticipated 10mg section 4. Blood pressure monitoring is recommended.
Allopurinol, immunosuppressants, corticosteroids, procainamide, cytostatics and other substances that may change the spc cell count: Increased likelihood of ramipril reactions see section 4. Excretion of lithium may be reduced 10mg ACE inhibitors and therefore lithium toxicity may be increased. Lithium level must be monitored. Antidiabetic agents including insulin: Hypoglycaemic reactions may occur. Blood glucose monitoring is recommended.